Provider Demographics
NPI:1174855951
Name:KANE, AMY GOLUB (OTR)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:GOLUB
Last Name:KANE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15354 W 148TH TER
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-5027
Mailing Address - Country:US
Mailing Address - Phone:913-461-4135
Mailing Address - Fax:
Practice Address - Street 1:15354 W 148TH TER
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5027
Practice Address - Country:US
Practice Address - Phone:913-461-4135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02031225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist